Describing Outpatient Physical Therapy Use Among Adolescents and Young Adults With Sickle Cell Disease: A Single-Center Retrospective Study

Abstract

Background: Physical impairments and functional limitations are common for individuals with sickle cell disease (SCD), leading to poor health-related quality of life (HR-QoL). Physical therapists provide interventions that restore functional capacity and promote independence, but it is unclear if these services are utilized by youth with SCD. This study aimed to describe physical therapy (PT) referral patterns and attendance rates among adolescents and young adults (AYA) with SCD, while also exploring if referral and receipt of outpatient PT were associated with age or HR-QoL. Methods: This retrospective chart review assessed youth aged ≥13 years who attended one or more multidisciplinary SCD clinic appointment between Septmenber 2010 and September 2023 where they completed one or more HR-QoL assessments. Demographic, PT referral and attendance, and HR-QoL data were collected from the electronic health record. Results: A total of 150 AYA with SCD met inclusion criteria, and 40% (n = 60) were referred for outpatient PT. Primary reasons for referral included joint pain/issues (50%), deconditioning (20%), and unspecific chronic pain (12%). Of those referred for outpatient PT, 61% (n = 37) completed one or more PT visits. Age did not predict referral (p = 0.12) or attendance (p = 0.81). Having a lower physical functioning HR-QoL score was associated with being referred for PT (p < 0.001) but not with attending PT (p = 0.26). Conclusion: AYAs with SCD are frequently referred to outpatient PT for a range of functional impairments and physical limitations. Findings suggest that AYA with SCD may face significant barriers to attending outpatient PT, and future studies are needed to identify and mitigate these challenges.